In response to reports of a memo obtained from the Department of Health and Human Services (HHS) that seeks to narrowly redefine sex under federal law as an immutable, binary construct determined by one’s genitalia at birth, more than 35 leading health professional associations and community health centers have signed-on to a letter strongly opposing this proposal as contrary to medical science.

The 38 organizations joining the letter recognize that gender is non-binary and cannot be determined solely by sex assigned at birth, and strongly urge that the Trump Administration reconsider this reported course of action that would have detrimental impact on the health and well-being of transgender and intersex individuals, and seriously impede nondiscrimination protections for these communities. The 38 organizations are listed below.

The letter asserts "gender identity and assigned sex at birth can be different one from the other, and that difference needs to be recognized in order to effectively guarantee access to care for transgender people. The reported memo’s narrow definition of sex also ignores the existence of intersex people, who are born with sex characteristics, such as anatomy or chromosomes, that do not fit the typical male/female binary definition set forth in the reported memo. Transgender and intersex people have existed throughout time and have unique health needs and lived experiences, necessitating that health care providers recognize these needs and differences as a part of providing high quality, affirming, and culturally competent care. The proposed definition of sex would instead ignore the existence of these populations, which in turn could worsen the health disparities experienced by transgender and intersex individuals and promote discrimination."

GLMA and the Fenway Institute, along with organizational partners, helped to organize this letter, which was sent to Attorney General Jeff Sessions, HHS Secretary Alex Azar, and Secretary of Education Betsy DeVos on November 5, 2018. The full letter can be seen by clicking here.

The reported plans to redefine sex were first made public October 21 by The New York Times based on an HHS memo that was leaked to the newspaper. The Times reported that HHS is proposing a legal definition of sex that would exclude transgender individuals under Title IX of the Education Amendments of 1972, which prohibits sex discrimination. A number of recent federal court rulings have found that anti-transgender discrimination constitutes sex discrimination under Title IX, and the sex discrimination provisions of the Civil Rights Act and Affordable Care Act. These rulings also were used as the legal basis for federal nondiscrimination rules affecting access by transgender people to healthcare, education, and other services that receive federal funding.

“The science is clear. Genetic sex chromosomes, anatomy, sexual orientation, gender and gender identity are separate. In many people they are aligned with one another, and in millions of other people they are not,” said GLMA President Gal Mayer, MD, MS, in a joint press release. “Any policy that tries to define an individual’s gender based solely on any one of these characteristics ignores decades of research and study, and contradicts the massive expertise of the healthcare providers and their associations represented on this letter. We can all confirm that gender and gender identity are not binary and in many cases not the same as the sex assigned at birth. Gender and gender identity exist on a spectrum, are personal experiences, are not always static, and can only be defined by the person living that experience.”

The health professional associations and community health centers joining the letter include:

Academy of Eating Disorders AGLP: The Association of LGBTQ Psychiatrists American Academy of Nursing American Academy of Pediatrics American Association for Geriatric Psychiatry American College Health Association American College of Physicians American Medical Student Association American Medical Women’s Association American Nurses Association American Psychiatric Association American Psychological Association American Public Health Association California LGBT Health and Human Services Network Callen-Lorde Clinicians for Progressive Care Denver Prevention Training Center Doctors for America Endocrine Society Fenway Health GLMA: Health Professionals Advancing LGBTQ Equality HIV Medicine Association Howard Brown Health National Association of Social Workers National LGBT Cancer Network National Physicians Alliance New York State American Academy of Pediatrics, District II Physicians for Reproductive Health Piedmont Health Services Progressive Doctors RAD Remedy Society for Physician Assistants in Pediatrics Society for the Psychological Study of Social Issues Society of General Internal Medicine The Lesbian, Bisexual, Gay and Transgender Physician Assistant Caucus Unites States Professional Association for Transgender Health Whitman-Walker Health World Professional Association for Transgender Health